Yesterday I went to the hospital for the first membrane sweep. It failed. The consultant couldn’t reach my cervix, which is still long, closed and posterior. The baby also has not fully engaged. So all in all, the conclusion is that labour looks likely to be far off. The conditions are unfavourable as the consultant put it. At 38 weeks this is not really that surprising, but it does bring the prospect of medical induction to the forefront since the general practice at the hospital is to induce IVF pregnancies early at 40 weeks, i.e. on my due date the 17th August. They will attempt a sweep again on the 14th which is just 3 days before my due date, but with the way things are looking I have my doubts whether there is any chance that it will help trigger labour naturally. Consequently I’m also starting to doubt the planned medical induction at 40 weeks. This I wonder might pose greater risks than allowing the baby to go overdue. Especially if the next sweep attempt reveal that conditions are still unfavourable.
So I have been google searching like crazy to try to find evidence for why IVF pregnancies should be induced early at no later than 40 weeks. It seems to be common practice in a lot of hospitals in the UK going by forum posts and the like. Although there are also many examples of this not being the case. The advice women, who have gone through IVF, are being given is clearly very inconsistent. And the evidence for the risk of going over the due date is sketchy at best, as far as I can find out. The reasons given are usually similar to what we have also been told – namely that the risk of still birth is higher due to the placenta not functioning as well beyond 40 weeks in IVF pregnancies.
Based on the lack of evidence there seems to be good reason to question the plan of induction at 40 weeks if the cervix is still not showing signs of being ready. We have decided to wait and see whether we should postpone the induction date. Maybe things will start happening in the mean time. Move on downwards baby boy 🙂
Last night we celebrated hitting the 37 week mark while watching the opening ceremony of the olympics. For us the countdown to the olympics has had a very special meaning because it’s taken us almost as long to get to this point as it has taken London to make the olympics possible. Now it’s all happening right around the corner from us here in East London while we are waiting in anticipation to meet our little baby boy. Everything is buzzing with a typical London combo of excitement and chaos. The chaos part is the worrying bit, because the hospital where I’m giving birth is right in the epicentre of it all. In fact it’s the officially designated hospital for the olympics. Not that the maternity unit as such will be affected by that, but the journey to the hospital will…
On Thursday 2. August we will get a taste of how difficult it is going to be to get there. I’m having a ‘membrane sweep’, which is the first step in the process of induction they have planned. We have been told that they want to ensure that I do not go over 40 weeks because it’s an IVF pregnancy. Apparently there is a higher risk of stillbirth when overdue because the placenta does not work as well anymore. Whether this has more to do with higher maternal age than IVF as such is difficult to say since the two factors often coincide. In any case, we do not see any reason to take the risk so we will go along with the plan.
A membrane sweep is viewed as the natural approach done prior to medical induction. It involves manually stretching the cervix and sweeping inside to try to encourage the release of prostaglandins, which are hormones that help trigger labour. It sounds rather unpleasant, but if it means a chance of avoiding medical induction it is worth the try. How effective it is is questionable. Presumably there should be about 50% chance that you go into labour within 48 hours. But it depends on how ready the cervix is at the time. If it doesn’t work they will do another one a week later. If nothing has happened by my due date (17. August) it will be time for medical induction. By then the olympics will be over, so it will be easier to get to the hospital. But I’m so hoping to avoid medical induction and I’m also just ready for him to come out now. So fingers crossed for an olympic baby!! 🙂